How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $2.95 Median $8.13 Typical High $30.20 | Facility | None | $2.95 | $8.13 | $30.20 |
Aetna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $30.20 | Professional | None | $2.95 | $2.95 | $30.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.47 Median $7.08 Typical High $20.89 | Facility | None | $3.47 | $7.08 | $20.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.95 Median $3.02 Typical High $6.17 | Professional | None | $2.95 | $3.02 | $6.17 |
Aultcare Setting Facility Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Facility | None | $3.89 | $3.89 | $3.89 |
CareSource Setting Facility Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Facility | None | $3.47 | $3.47 | $3.47 |
CareSource Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $4.68 | Professional | None | $4.68 | $4.68 | $4.68 |
Cigna Setting Facility Modifier None Typical Low $5.50 Median $6.31 Typical High $9.55 | Facility | None | $5.50 | $6.31 | $9.55 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | None | $2.95 | $2.95 | $2.95 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $6.03 Median $6.31 Typical High $8.51 | Facility | None | $6.03 | $6.31 | $8.51 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $3.72 | Professional | None | $2.95 | $2.95 | $3.72 |
Molina Setting Professional Modifier None Typical Low $3.55 Median $4.07 Typical High $4.79 | Professional | None | $3.55 | $4.07 | $4.79 |
SummaCare Setting Professional Modifier None Typical Low $2.95 Median $3.24 Typical High $5.75 | Professional | None | $2.95 | $3.24 | $5.75 |
United Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $4.68 | Professional | None | $3.16 | $3.16 | $4.68 |
2 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.44 Median $0.44 Typical High $4.47 | Professional | 55 · Aftercare only | $0.44 | $0.44 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $3.02 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $3.02 |
Where Ohio sits
The same service costs 6.0 times more in Oklahoma than in Wyoming. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Ohio· 31st of 51
$3.16
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.